Recent expansion of large scale confined animal feeding operations (CAFOs) is generating a wide variety of health concerns in the USA and other nations. Air and ground water pollution from swine CAFOs are of particular concern in North Carolina, where industrial hog production has expanded rapidly since the 1980s. Airborne emissions are composed of hundreds of agents including hydrogen sulfide, ammonia, volatile organic compounds, and dusts or particulate matter that contains biological materials including proteins and endotoxins. Nitrates, pathogens, and antibiotic residues have been documented in ground water near swine CAFOs. The investigators propose a series of community-based participatory studies that will (1) quantify community exposures to hydrogen sulfide, volatile organic compounds, dusts, and endotoxins; (2) evaluate relationships between air emissions and perceptions of odor and irritation; (3) measure exposures to airborne emissions from livestock operations to strengthen the design of an already-funded health symptom survey; and (4) prospectively quantify relationships between ambient exposures and respiratory symptoms, lung function, and other health status measures among persons residing near swine CAFOs in North Carolina. They will also (5) conduct surveillance for nitrates and antibiotic residues in well water of study participants. Bacterial flora of any participants who report a history of drinking water contaminated by veterinary antibiotic residues will be tested for antibiotic resistance. Due to widespread distrust of biomedical research in poor and people of color communities where NC swine CAFOs are concentrated, community-based participatory research approaches are required for addressing these health issues. The proposed studies build on five years of community-driven research conducted by Concerned Citizens of Tillery and the University of North Carolina School of Public Health, as well as on extensive research on chemical odorants and their effects, and on water quality, conducted by other project collaborators. This project will provide new scientific data on exposures and human health effects of swine CAFOs and increase the capacity of communities in eastern NC to improve public health conditions in an underdeveloped region of the United States.